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General NPI Number Information
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NPI Number | 1710971882
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Entity Type | Individual
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Provider Name | ROBERT G PICKERILL M.D.
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Gender | Male
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Dates
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Enumeration Date | 09/06/2005
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Last Update Date | 03/08/2016
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Provider Practice Location Address
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Address Line | 1086 FRANKLIN ST
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City | JOHNSTOWN
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State | PA
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Zip | 15905-4305
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Country | US
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Telephone | 814-242-0520
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Fax |
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Provider Business Mailing Address
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Address Line | 1107 CLUB DR
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City | JOHNSTOWN
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State | PA
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Zip | 15905-1906
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Country | US
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Telephone | 814-242-0520
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | MD019294E
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License Number State | PA
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